Sen. Leland Yee, D-San Francisco, plans to call a hearing of the Senate Human Services Committee, which he chairs, in response to last month’s U-T Watchdog series, “Deadly Neglect.”

The series found at least 27 deaths due to abuse or neglect in assisted living facilities in San Diego County, raising questions of whether $150 maximum fines for the homes are too low and state inspections are too rare.

Yee’s committee oversees the state Department of Social Services, which regulates assisted living centers. He sat down at the U-T with reporters from the newspaper and the CHCF Center for Health Reporting.

Yee, who is running for secretary of state, was in San Diego to meet with industry representatives.

Q: What did you learn in your meeting with industry today?

A: Because of the article, they’ve done internal reviews of their procedures and they have now increased some of their quality assurance arrangements – who’s in there, what is the quality of the talent within their quality assurance organizations, operations.

They clearly know that there are problems, and they are in fact trying to bolster the level of technical help so that they will now do their own independent review. And then in some of the smaller operations where they don’t have the talent in house, they are now contracting with third party reviewers to kind of help them.

I think that one of the good things about your work is that you’ve gotten the industry to recognize that there’s a problem. You’ve gotten the state to realize that there’s a problem. And so there is now a lot of discussion about changes. I think the changes are the following: a willingness on the part of the industry to increase fees so that there are more site visits. There is discussion about increasing the fines, because it just doesn’t make sense that if a person dies, the penalty on that is a lot less than if a condor dies. So you’ve got that going.

The series

I think the other problem is the following – that either you guys have caused to happen, or that because of the work that you’ve done, it has reignited the push to move forward with maybe a more comprehensive look at how do you license these kinds of facilities.

There is an appetite now, because of the work that you guys are doing, to really tax themselves.

Q: Meaning?

A: Increased fees. The problem is that if you’re going to go from once every five years to once every three years, you’re going to have to have more inspectors. And if they’re going to be dedicated just for the elderly population, or aged population, then you’re going to have training, you’ve got to really ramp up. Because the problem now is that you’ve got individuals in the Community Care Licensing field office that tend to move from one group to the other.

Q: Kind of like liberal arts, instead of specialties?

A: Right, right, right. They don’t do that any more, so, as a result, you have to kind of know everything about all the different things, and you end up with having individuals that don’t know anything about anything at all. So that is going to require some structural changes within the Department of Social Services. I think that those are the tough, tough questions that need some answers. Part of the reason why we’re going to hold this hearing is that there are a lot of issues that are very clearly on the surface, but then there are a lot of underlying issues that have not yet been raised that I think we ought to raise.

Q: When will the hearing be?

A: We will come back in January, and it will take some time to get used to things. So, probably February.

Q: And you’ll be deciding at that point, the committee, I presume, you, what types of bills you’ll be proposing?

A: No. What we’ll do, we will hold the hearing, and then we’ll figure out the bills. Now, as I said, this is a much larger issue now. I think that the department may want to get ahead of itself, and ahead of everything else, because, clearly, this is not a good thing going on right now. It’s clearly a problem that’s hanging over the department.

So they may concede the fact that we don’t need any more hearings about the fact we’ve got to increase fees, so we can make these site visits more frequent. So they may talk about, how do we then fix this problem sooner rather than later. There may be bills introduced, there may be bills revived.

Q: Are you satisfied at this point that the leadership of DSS is doing all it can to protect the safety of seniors in these homes?

A: I don’t want to say anything in terms of their ability. But what I can say is that it’s clear from your article that the state and the department are not doing enough. You can’t have deaths in the state of California and not somehow understand how did it happen and how you could prevent it. Thus far, the only answer seems to be, well, we’re going to have more site visits. And I don’t know if that’s going to necessarily be the answer.

Q: What concerns do you have?

A: One of the concerns about the increasing fees is that while, on one hand, it’s important to do that, the other thing is that you don’t want to price anybody out of business. So we’ve got to then figure out, how do you tier the fees so that it’s allocated more fairly based on the number of beds and the number of programs and just the economic base that each of these programs is working from.

With that said, I think one of the things I’m also very conscious of is that I don’t want the six-beds to go away. I can see that the giant companies will really benefit from that, and as you can imagine, the larger companies are in a much better position to kind of do things on their own and not be as sensitive to what the community may want, and so on.

Q: Do you think the police agency within DSS should answer to a police chief rather than an administrator?

A: Well, yes.

Q: So that’s something you may look at, going forward?

A: There are a number of things ... It’s like the fox guarding the hen house.

Q: You had said that you don’t think necessarily that more visits is the answer, or the sole answer, to what’s going on. What other thoughts do you have?

A: That’s one of the things that I want to have a hearing over – one of the major topics of the hearing. It seems to me – the analogy I would make is as a psychologist. When I go out to practice, and the state of California gives me a license to practice, the assumption that the state of California makes is that this guy is competent. He can do the job. He can do the work in a responsible, ethical, professional way.

What I don’t want to do is give someone a license to operate an assisted living facility, and then the operators basically will now say, OK, tell me how to run this thing. Tell me the do’s and don’ts, and how do I run it in an ethical, professional, competent way.

I think the general public assumes that if the state of California gives you a license to operate, you know what to do.